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Organization
FAMILY SPEECH & THERAPY SERVICES, LLC
Active
Organization
FAMILY SPEECH & THERAPY SERVICES, LLC
Active
Other names
Sora Pediatric Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA SUE LONSKY (CHIEF EXECUTIVE OFFICER)
(612) 817-0306
Entity
Organization
Contact information
Practice address
1891 STATION PKWY NW, ANDOVER, MN 55304
(763) 755-4275
(763) 755-4261
Mailing address
1891 STATION PKWY NW, ANDOVER, MN 55304
(763) 755-4275
(763) 755-4261
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
7012
MN
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01043879
PREFERRED ONE
MN
05
—
150165800
—
MN
01
—
73G75FA
BLUE CROSS BLUE SHIELD
MN
01
—
99915
HEALTHPARTNERS
MN
Enumeration date
01/26/2007
Last updated
01/07/2019
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